The title of this thread should be changed as the article detailed a several cardiac issues with elite national level athletes. AF, VT are not cardiac arrest. The article's quoted experts in the field are unable to document the important questions of "how much is too much?", "who is likely to experience such symptoms?" and "when such incidents could occur". Furthermore, there is little information presented on the "Jane and Joe Six-Packs" who compose most of the weekend warriors. Until such data is presented, the mass majority of weekend warriors will continue to rely upon common sense and remember what the late MD/runner/writer George Sheehan stated "you are an experiment of one".

I agree with your premise, but for the record, VT is a type of cardiac arrest. AF is an increasing issue, but not usually an immediate threat unless someone goes into rapid AF and has hemodynamic compromise.

It is a poorly written article with a lot of sensationalism in the beginning, which is often the case when a fit individual/athlete dies, but at least there is rebuttal.

These cases are extremely rare and no one should extrapolate to the conclusion that exercising and doing physical activity promotes risk of sudden death. It is exactly the opposite-the AHA suggests 5 sessions of 30 minutes of aerobic activity weekly to DECREASE long term cardiac risk.

http://www.heart.org/...cle.jsp#.WsAXrJch1PY

There is data that during the course of exercise there is a slight increased risk, which is the price you pay for achieving the longer term goal.

https://www.ncbi.nlm.nih.gov/pubmed/2073659

The 'Walker' quote --"I probably feel one of the reasons for this – and it hasn't been absolutely proven but it's quite logical – is that if you push yourself too hard, you're overstretching all the mechanisms in the body," Walker said. Including the heart. "Like anything that's overworked, it eventually gives up"--is absolutely unfounded.

LeGersh's retort is better supported by the data. But, it is true that endurance sports causes dilation of the heart, a normal physiological response, which can have some consequences. It also dilates the atrium which is where the pacemaker is, the SA node, and there is an increased incidence of afib. I had been saying this for years as I've seen it in my athlete patients and it's now in the literature as a proven fact.

https://www.ncbi.nlm.nih.gov/...articles/PMC5135187/


Heart disease is still the number one killer and can take anyone-some have more risk and others less risk. Being an active athlete puts you in a lower risk group-not zero risk, but lower. If you have significant risk factors, then getting checked out prior to training for that big event is a reasonable thing to do. These articles often do more damage than good every time they come out...

Dale

Sigh, guess I’ll go grab some cake and ice cream and go flop on the couch. I can always pop some heart pills and insulin if my snacking gets out of hand. And be sure to text and drive while avoiding airplanes because those scare me too. (All said while smoking a cig).

In a nutshell, while there might be a slightly increased risk of a heart problem while exercising, the overwhelming evidence is that exercise offers much more benefit than risk. Period.

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Trust me I’m a doctor!
Well, I have a PhD :-)

Exercise and extreme endurance are two different things though and that’s the big unanswered question-does the scarring etc lead to heart problems.

VT ventricular tachycardia can be symptomatic or none symptomatic. You can also be pulseless in this cardiac rhythm (aka, dead). As for the risks? How a about the risks of no or little exercise? Arteriolosclerosis seems to be what leads to the greatest risk to life. This is kind of like saying that airbags can hurt you when deployed, but neglect to mention that that same airbag that broke your nose also just saved your life.

And that question is unlikely to get answered any time soon. The pool of people for research is very small.

But it doesn't change anything. In the big scheme of things exercise is overwhelmingly beneficial for the majority of people. There is always going to be a minority of people who might have a heart problem exacerbated by exercise. But it is only a minority.

Unfortunately that's a message that gets buried when the media focus on the occasional, albeit very tragic, death from heart failure during exercise is highlighted.

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Trust me I’m a doctor!
Well, I have a PhD :-)

Are there tests that can be done to see how your heart 'looks' and maybe give you a clue if you are at risk for these sorts of problems? I get an EKG as part of my 'Executive' physical, but wondering if it might be worth doing something more for risk management?

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Dimond Bikes Superfan

Echocardiogram

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Make Inside Out Sports your next online tri shop! http://www.insideoutsports.com/

 


Yes. You could have an ultrasound of your heart. If you are an IM , marathon runner it will show an enlarged heart. That's a normal adaptation. wall muscle thickening etc.... But they can also see the heart motion and evaluate ejection fraction. An EKG would most likely show a prominent QRS ( LVH.... left ventricular hypertrophy) segment, but again this is expected in trained athletes.

I've been paying attention to the cardiac issues of long time endurance athletes, especially as they age. Today, I was scheming a Wednesday run with a local group and discovered that the long time leader of organized running in Nashville, TN, USA died from ventricular fibrillation ( https://www.tennessean.com/...es-age-72/456869002/). 72 years old, long time endurance athlete (runner), had just completed a half marathon in March. Was helping to set up a weekend run course for the Nashville Striders (a local club), went into V-Fib, transported to hospital but did not survive. There are plenty of studies documenting this type of outcome and plenty of folks who point out that regular exercise *decreases* cardiac and cardiopulmonary deaths. Still, as a Striders member an an aging athlete engaged in endurance sports for 30+ years, this one hits home in a particularly impactful way. Just FYI and a PSA to do what you can to get evaluated for cardiac issues, even if (especially if?) you have been doing what we do for a long time.

EDIT: typo fixed.

And cardiac arrest is not a heart attack, per se. And neither is heart failure (from the article).

People in general seem to use heart attack, cardiac arrest and heart failure interchangeably when the terms actually describe different medical conditions.